KHN’s ‘What the Health?’: The Health Agenda Still on Hold

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Democrats on Capitol Hill missed their deadline to finish two huge bills that constitute the bulk of President Joe Biden’s domestic agenda, but negotiations continue over expansions to major health programs, as well as ways to rein in prescription drug costs.

Meanwhile, the Biden administration issued regulations to implement last year’s law to limit “surprise” medical bills to patients who get care outside their insurance networks. Health providers — doctors and hospitals — are already complaining that they will be asked to pick up too much of the bill to protect patients.

This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Tami Luhby of CNN and Kimberly Leonard of Insider.

Among the takeaways from this week’s episode:

• Progressive Democratic lawmakers successfully used their leverage to thwart passage of a bill funding traditional infrastructure projects before they secure a deal on spending for new and enhanced domestic policy initiatives. Negotiations might not move any faster, though, and it appears an ugly fight still looms over what could get cut from those domestic plans.
• One major debate seems to revolve around expanding Medicare benefits versus providing coverage to low-income people in the 12 states that refused to expand Medicaid under the Affordable Care Act. Medicare benefits might be a more popular lure with older voters, an important voting bloc, and Republicans would be less likely to come back later and overturn that initiative. Medicaid expansion, however, is an issue dear to many Democrats who see it as important to finishing the ACA legacy. They also say it may give Democrats in those 12 conservative states a good campaign hook.
• The rift between progressives and moderates over “social infrastructure” spending in the reconciliation bill has shed light on the difficult task of brokering major legislation. Clinching a spending bill for even $1.5 trillion would be an enormous accomplishment for the Democrats. But their infighting projects failure to the public. And that can have repercussions at the ballot box.
• New rules on protecting consumers from surprise medical bills — announced this week by the Biden administration — put limits on the arbitration process set up by the law passed by Congress last year. And those limits appear to favor the insurance industry over hospitals and other health care providers.
• A poll from KFF shows the big divide over vaccinations between Democrats and Republicans. Even former President Donald Trump, who was booed at a recent rally when suggesting that the audience get vaccinated, may not be able to bridge the gulf.
• One group that has been reluctant to get vaccinated are rural residents —a population also hit hard by the opioid epidemic. That crisis led many rural Americans to grow wary of the health care industry, which may influence their views on getting vaccinated against covid-19.
• The House last week passed a bill to codify a woman’s right to an abortion. It’s a landmark bill but likely to die in the Senate. Part of the problem for groups seeking to buttress the right to abortion is that states handle the issue so differently. In those conservative states where lawmakers are seeking to limit or deny access to abortion, the issue may be front and center. But many states have not restricted abortion facilities and people in those areas may not see the issue as imperative.

Also this week, Rovner interviews Anna Flagg, a data journalist for the Marshall Project, about a story she wrote on how a major medical education report from 1910 inadvertently contributed to racial inequities in health care that persist today.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: Science’s “Top Secret: U.S. National Academy of Medicine Keeps Expulsions Quiet,” by Meredith Wadman

Alice Miranda Ollstein: The New York Times’ “‘Mandates Are Working’: Employer Ultimatums Lift Vaccination Rates, So Far,” by Shawn Hubler

Tami Luhby: The Wall Street Journal’s “Vaccination Status Is the New Must-Have on Your Resume,” by Patrick Thomas

Kimberly Leonard: Insider’s “Walmart’s Health Clinics Are Struggling With Basic Functions Like Billing, Imperiling the Company’s Push to Upend Care,” by Shelby Livingston

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KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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